Jordan Loewenstein, D.C. | La Jolla Chiropractor
Quick answer: dizziness after a car accident usually comes from one of three places: the neck (the upper neck joints and muscles feed position information to your balance system, and after whiplash that signal is scrambled), the inner ear (crystals knocked loose by the impact, causing short spins when you turn your head or lie down), or a concussion (dizziness with fog, nausea and light sensitivity). I treat the first two in the office: neck-driven dizziness responds to treatment of the neck, and inner-ear crystals are repositioned with the Epley manoeuvre, often in a single visit. Dizziness with double vision, slurred speech, severe headache, vomiting, weakness or trouble walking is an emergency department problem first.
Dizziness is one symptom where I want you to rule out the serious causes before anyone treats the neck. Go to the emergency department if the dizziness comes with any of these: double vision or loss of vision, slurred speech or trouble swallowing, numbness or weakness on one side or in the face, severe headache, repeated vomiting, confusion or drowsiness, fainting, trouble walking in a straight line, or a sudden onset of intense spinning that will not stop. Those can indicate bleeding, a concussion that needs monitoring, or injury to one of the arteries in the neck, and they need imaging first. If you are cleared, I pick up from there.
The most common type I see after whiplash. The upper neck has a dense supply of position sensors that tell the brain where the head is relative to the body. After a whiplash strain, with the joints stiff and the muscles guarding, that information arrives distorted and conflicts with what the eyes and inner ear are reporting. The result is a vague unsteadiness, light-headedness or a sense of being “off,” rather than true spinning. It tends to come with neck pain and stiffness, gets worse with neck movement or after a long time at a screen, and improves as the neck improves.
Benign paroxysmal positional vertigo. The inner ear contains tiny calcium crystals that can be shaken out of place by a hard impact. When they drift into the wrong canal, turning the head, rolling over in bed or looking up triggers a short, intense spin lasting seconds to a minute. Between spells you feel fine. This is very treatable: the Epley manoeuvre, a sequence of head positions that guides the crystals back where they belong, resolves it in one or two sessions for most people, and I perform it in the office when the positional test is positive. It is important not to confuse it with the neck, because the treatments are completely different.
A whiplash motion can cause a concussion without any blow to the head. Dizziness here is more constant, often with mental fog, headache, nausea, sensitivity to light and noise, fatigue and trouble concentrating. Concussion symptoms are co-managed with your physician; the neck component, which is almost always present too, is treated alongside.
The history does most of the work: is it spinning or unsteadiness, how long does an episode last, what triggers it, what came with it. Then the exam: neck range of motion and palpation of the upper neck, a check of whether neck movement with the head held still reproduces the symptom, a screen for nerve and artery signs, a positional test for the inner ear, and a concussion symptom check. Most people have more than one thing going on, and the plan follows the exam.
When the picture is cervicogenic, the dizziness responds to the same staged neck care as the rest of the whiplash: gentle mobilisation of the upper neck joints, soft tissue work on the suboccipital muscles, heat and electrical stimulation to settle guarding, then full adjustments and deep neck flexor strengthening as the inflammation settles. People usually notice the unsteadiness fading as rotation of the upper neck comes back, typically over two to four weeks.
When the positional test points to the inner ear, I do the Epley manoeuvre that same visit rather than treating the neck for something that is not the neck; most people feel the difference immediately, and a second session is sometimes needed. When the picture is concussion, I coordinate with your physician and treat the neck alongside, because an untreated neck is one of the main reasons post-concussion dizziness lingers.
The first visit is 45 minutes and includes all of the above plus a decision about imaging based on your symptoms. Follow-ups are 30 minutes. Same-day visits when possible, including Sundays. Lien-based care and an attorney introduction if you need one, as described on my car accident injury page.
Why am I dizzy after a car accident?
Most often because the strained upper neck is sending distorted position information to the balance system (cervicogenic dizziness). Other causes are inner ear crystals dislodged by the impact (BPPV) and concussion. Serious causes need to be ruled out first.
When is dizziness after a car accident an emergency?
If it comes with double vision, slurred speech, one-sided weakness or numbness, severe headache, repeated vomiting, confusion, fainting, trouble walking, or sudden intense spinning that will not stop. Go to the emergency department.
Can whiplash cause dizziness?
Yes. Cervicogenic dizziness is common after whiplash. It feels like unsteadiness or being off rather than spinning, comes with neck stiffness, and improves as the neck is treated.
How is dizziness from the neck treated?
By treating the neck: mobilisation and later adjustment of the upper neck joints, soft tissue work on the suboccipital muscles, and strengthening. Dizziness usually fades as upper neck rotation returns. If the inner ear is the cause instead, the Epley manoeuvre is done in the office.
How long does dizziness last after a car accident?
Neck-driven dizziness typically settles over two to four weeks with treatment. BPPV usually resolves in one or two Epley sessions, which I do in the office. Post-concussion dizziness usually improves over weeks but can linger if a neck component is left untreated.
Can a chiropractor treat vertigo after a car accident?
Yes. If the positional test shows BPPV (dislodged inner-ear crystals), I perform the Epley manoeuvre in the office, which resolves it in one or two sessions for most people. If the dizziness is coming from the neck, treating the upper neck resolves it.
Unsteady since a crash? Call (858) 558-3111 or book online for a same-day evaluation at my UTC San Diego office.
Dr. Loewenstein diagnoses the actual source of your pain before treating it — soft tissue work, adjustment, and rehab in one visit. Most major insurance accepted, no packages or contracts.